Jenna Anne Davis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.026480 Issued in IL

Practice address

1503 Lindell Blvd
Granite City, IL 62040-3837

Phone

(618) 709-4125

Fax

(618) 709-4126

NPI assigned

Mar 9, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1184371064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 HODGES AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620405607",
            "telephone_number": "618-709-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 LINDELL BLVD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403837",
            "telephone_number": "618-709-4125",
            "fax_number": "618-709-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNA",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.026480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Cummins
• Desiree Michele Dace
• Darin Chiropractic, LLC
• Christina Marie Darin, DC
• Shawnery Davidson, PTA
• Brittany Davison, RN
• DCL Medical Laboratories LLC
• Pamela Anne Dean, RPH
• Christopher L. Deboe, BSN, RN
• Emilie Diane Delp, LCSW

• Physical Therapist in Granite City, IL
• Providers in Granite City, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.